The overall goals of the candidate for this KO1 award are to gain in-depth expertise in developing and testing behavioral interventions that support diabetes prevention programs for young adults with increased risk for type 2 diabetes and to build collaborative partnerships to conduct subsequent community-based research in this area. The long-term goal of the candidate is to be an independent nurse researcher able to develop tailored diabetes prevention programs for community-living individuals and to translate the findings into broader clinical practice. The obesity epidemic and endemic physical inactivity place American young adults at a high risk for developing type 2 diabetes (T2DM) and its complications. T2DM is a progressive chronic disease, but its progression is preventable and reversible with appropriate actions such as adoption of a healthy lifestyle regimen. However, very few studies have been conducted among American young adults who are at increased risk for type 2 diabetes. Currently, we have poor understanding of: 1) young adults'perceptions of T2DM;2) their subjective experiences of screening for and diagnosis and management of pre-diabetes and asymptomatic T2DM;and 3) strategies to design and implement effective and efficient age-specific diabetes prevention programs. Additionally, we have limited information about accessing at-risk young adults in the community or about motivating them to engage in early screening and preventive activities to delay or prevent the onset of T2DM. The purpose of the proposed study is to provide the basis for a testable program aimed at preventing type 2 diabetes in young adults with increased risk for T2DM. To attain this goal, a two-phased project is proposed including mixed methods formative and pilot intervention studies. In the formative study, surveys and focus group interviews will be used to assess educational and informational needs for a diabetes prevention program in young adults with increased risk for T2DM. [We will recruit a group of young adults, using as inclusion criteria the American Diabetes Association guidelines for testing for diabetes in asymptomatic adults: overweight/obese (BMI e 25) and physically inactive, having a T2DM family history, being a member of a high- risk ethnic population, or having high blood pressure (systolic BP e130 or diastolic BP e85).] Based on results from this study, a 12-week pilot intervention will be developed that will allow for individual tailoring. Advanced technology (e.g., Pocket computers and social network media) will be employed in the pilot intervention to enhance the feasibility and acceptability of the intervention for young adults. The intervention will then be tested in a pilot trial. The overall study will inform future research. It will elicit information on perceptions of risk for T2DM in a younger population about which little is known and test a diabetes prevention program in younger populations which has the potential to be a cost-saving approach to prevent diabetes and its many complications, to save health costs and to improve quality of life, and 3) considers developmental tasks and educational needs of young adults, an understudied group. Additionally, this research experience will provide the candidate opportunities to :1) improve understanding of young adults'perception of health, type 2 diabetes risk, and healthy lifestyle behaviors, 2) expand expertise in qualitative research, 3) enhance practical skills to design and test an age-specific behavioral intervention program. Atlanta, a metropolitan area with diverse ethnic populations, is an ideal environment for testing a diabetes prevention program for young adults: approximately 62% of the population is comprised of minority groups who are vulnerable to T2DM. Emory University provides an excellent training environment evidenced by nationally and internationally recognized mentors, experts in the content and target population of the project, adjacency to the Centers for Disease Control and Prevention, and access to the NIH funded Atlanta Clinical and Translational Science Institute (ACTSI). PUBLIC HEALTH RELEVANCE: This Mentored Research Scientist Development Award (K01) provides Dr. Cha with support for an intensive, supervised career development experience. The program is designed to strengthen her capacities to be an independent diabetes nurse researcher who successfully translates research findings into nursing education and clinical practice. The proposed research project will provide important information on young adults with increased risk for type 2 diabetes, under-studied population, and lead to a larger project.